Abdominal laparoscopic surgery gained popularity in the late 1980s, when benefits of laparoscopic removal of the gallbladder over traditional (open) surgery became evident. Reduced postoperative recovery time, markedly decreased post-operative pain and wound infection, and improved cosmetic outcome are well established benefits of laparoscopic surgery, derived mainly from the ability of laparoscopic surgeons to perform an operation utilizing smaller incisions of the body cavity wall.
In laparoscopic abdominal procedures for example, the abdominal cavity is generally insufflated with CO2 gas to a pressure of around 15 mm Hg. Insufflation generally provides adequate space within the abdominal cavity to visualize and work therein. However, insufflation hinders if not entirely prevents a patient from breathing on their own. Thus, a patient is typically sedated and put on a ventilator during a surgical procedure involving insufflation despite the risk of one or more complications that can arise from sedation and artificial respiration, e.g., adverse reaction to sedation drugs, apnea, hypotension, aggravation of a pre-existing condition such as a heart defect, etc.
The abdominal wall is pierced, usually following insufflation of the abdominal cavity, and one or more laparaoscopic instruments are inserted into the abdominal cavity, either directly or through one or more cannulas. A laparoscopic telescope connected to an operating room monitor can be used to visualize the operative field and can be placed through one of the cannulas. Other laparoscopic instruments such as graspers, dissectors, scissors, retractors, etc. can be placed through the other cannula(s) to facilitate various manipulations by the surgeon. It can be difficult for a single medical professional to handle numerous surgical instruments simultaneously inserted into a patient. However, having multiple medical professionals handle various instruments simultaneously inserted into a patient can crowd the surgical space and can increase the complexity of manipulating multiple instruments in an effective cooperative relationship at the surgical site. These problems can unduly lengthen the duration of the surgery, potentially increasing the risk of patient complications.
Moreover, if an instrument needs to be held in a static position, e.g., to provide stable visualization of a surgical site, to retract tissue away from a surgical site while another instrument(s) performs another aspect of the surgical procedure at the surgical site, etc., it can be difficult to hold the instrument steady by hand.
Accordingly, there is a need for methods and devices which allow laparoscopic procedures to be performed with an enhanced ability to access a surgical site and to position and visualize surgical instruments at the surgical site.